MEDICARE: PAULA JO WASHINGTON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	H5089	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	89585G	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1992728794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA JO WASHINGTON M.D.

Provider Business Mailing Address
First Line	:	8267 ELMBROOK DR
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75247-4030
Country	:	US
Telephone Number	:	214-237-1664
Fax Number	:	214-237-1864

Provider Business Practice Location Address
First Line	:	8267 ELMBROOK DR
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75247-4030
Country	:	US
Telephone Number	:	214-237-1664
Fax Number	:	214-237-1864

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	07/08/2007

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